| National Provider Identifier [NPI]: | 1427290030 |
| Last Name Of The Provider | BALTZ |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1412 3/4 N HAYWORTH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST HOLLYWOOD |
| Zip Code Of The Provider | 900463809 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 829 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 121122 |
| Total Medicare Allowed Amount | 80536.46 |
| Total Medicare Payment Amount | 61464.24 |
| Total Medicare Standardized Payment Amount | 67652.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 829 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 121122 |
| Total Medical Medicare Allowed Amount | 80536.46 |
| Total Medical Medicare Payment Amount | 61464.24 |
| Total Medical Medicare Standardized Payment Amount | 67652.02 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 110 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 71 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 37 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 3.3641 |